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Dietary fibre in food and protection against colorectal cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC): an observational study.

Abstract

BACKGROUND

Dietary fibre is thought to protect against colorectal cancer but this view has been challenged by recent prospective and intervention studies that showed no protective effect.

METHODS

We prospectively examined the association between dietary fibre intake and incidence of colorectal cancer in 519978 individuals aged 25-70 years taking part in the EPIC study, recruited from ten European countries. Participants completed a dietary questionnaire in 1992-98 and were followed up for cancer incidence. Relative risk estimates were obtained from fibre intake, categorised by sex-specific, cohort-wide quintiles, and from linear models relating the hazard ratio to fibre intake expressed as a continuous variable.

FINDINGS

Follow-up consisted of 1939011 person-years, and data for 1065 reported cases of colorectal cancer were included in the analysis. Dietary fibre in foods was inversely related to incidence of large bowel cancer (adjusted relative risk 0.75 [95% CI 0.59-0.95] for the highest versus lowest quintile of intake), the protective effect being greatest for the left side of the colon, and least for the rectum. After calibration with more detailed dietary data, the adjusted relative risk for the highest versus lowest quintile of fibre from food intake was 0.58 (0.41-0.85). No food source of fibre was significantly more protective than others, and non-food supplement sources of fibre were not investigated.

INTERPRETATION

In populations with low average intake of dietary fibre, an approximate doubling of total fibre intake from foods could reduce the risk of colorectal cancer by 40%.

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  • Authors+Show Affiliations

    ,

    MRC Dunn Human Nutrition Unit, Cambridge, UK.

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    Source

    Lancet (London, England) 361:9368 2003 May 03 pg 1496-501

    MeSH

    Adult
    Aged
    Colorectal Neoplasms
    Dietary Fiber
    Feeding Behavior
    Female
    Follow-Up Studies
    Humans
    Incidence
    Life Style
    Linear Models
    Male
    Middle Aged
    Prospective Studies
    Risk Factors
    Surveys and Questionnaires

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    12737858

    Citation

    Bingham, Sheila A., et al. "Dietary Fibre in Food and Protection Against Colorectal Cancer in the European Prospective Investigation Into Cancer and Nutrition (EPIC): an Observational Study." Lancet (London, England), vol. 361, no. 9368, 2003, pp. 1496-501.
    Bingham SA, Day NE, Luben R, et al. Dietary fibre in food and protection against colorectal cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC): an observational study. Lancet. 2003;361(9368):1496-501.
    Bingham, S. A., Day, N. E., Luben, R., Ferrari, P., Slimani, N., Norat, T., ... Riboli, E. (2003). Dietary fibre in food and protection against colorectal cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC): an observational study. Lancet (London, England), 361(9368), pp. 1496-501.
    Bingham SA, et al. Dietary Fibre in Food and Protection Against Colorectal Cancer in the European Prospective Investigation Into Cancer and Nutrition (EPIC): an Observational Study. Lancet. 2003 May 3;361(9368):1496-501. PubMed PMID: 12737858.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Dietary fibre in food and protection against colorectal cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC): an observational study. AU - Bingham,Sheila A, AU - Day,Nicholas E, AU - Luben,Robert, AU - Ferrari,Pietro, AU - Slimani,Nadia, AU - Norat,Teresa, AU - Clavel-Chapelon,Françoise, AU - Kesse,Emmanuelle, AU - Nieters,Alexandra, AU - Boeing,Heiner, AU - Tjønneland,Anne, AU - Overvad,Kim, AU - Martinez,Carmen, AU - Dorronsoro,Miren, AU - Gonzalez,Carlos A, AU - Key,Timothy J, AU - Trichopoulou,Antonia, AU - Naska,Androniki, AU - Vineis,Paolo, AU - Tumino,Rosario, AU - Krogh,Vittorio, AU - Bueno-de-Mesquita,H Bas, AU - Peeters,Petra H M, AU - Berglund,Göran, AU - Hallmans,Göran, AU - Lund,Eiliv, AU - Skeie,Guri, AU - Kaaks,Rudolf, AU - Riboli,Elio, AU - ,, PY - 2003/5/10/pubmed PY - 2003/5/30/medline PY - 2003/5/10/entrez SP - 1496 EP - 501 JF - Lancet (London, England) JO - Lancet VL - 361 IS - 9368 N2 - BACKGROUND: Dietary fibre is thought to protect against colorectal cancer but this view has been challenged by recent prospective and intervention studies that showed no protective effect. METHODS: We prospectively examined the association between dietary fibre intake and incidence of colorectal cancer in 519978 individuals aged 25-70 years taking part in the EPIC study, recruited from ten European countries. Participants completed a dietary questionnaire in 1992-98 and were followed up for cancer incidence. Relative risk estimates were obtained from fibre intake, categorised by sex-specific, cohort-wide quintiles, and from linear models relating the hazard ratio to fibre intake expressed as a continuous variable. FINDINGS: Follow-up consisted of 1939011 person-years, and data for 1065 reported cases of colorectal cancer were included in the analysis. Dietary fibre in foods was inversely related to incidence of large bowel cancer (adjusted relative risk 0.75 [95% CI 0.59-0.95] for the highest versus lowest quintile of intake), the protective effect being greatest for the left side of the colon, and least for the rectum. After calibration with more detailed dietary data, the adjusted relative risk for the highest versus lowest quintile of fibre from food intake was 0.58 (0.41-0.85). No food source of fibre was significantly more protective than others, and non-food supplement sources of fibre were not investigated. INTERPRETATION: In populations with low average intake of dietary fibre, an approximate doubling of total fibre intake from foods could reduce the risk of colorectal cancer by 40%. SN - 0140-6736 UR - https://www.unboundmedicine.com/medline/citation/12737858/Dietary_fibre_in_food_and_protection_against_colorectal_cancer_in_the_European_Prospective_Investigation_into_Cancer_and_Nutrition__EPIC_:_an_observational_study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0140673603131741 DB - PRIME DP - Unbound Medicine ER -